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AA ST2 > Teaching > Flashcards

Teaching Flashcards

1
Q

lung nodules <5mm have risk of cancer same as

A

ano other lobe without a nodule

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2
Q

M1a vs b vs c for lung tumours

A

met to effusion or other lung
extrathoracic site
???

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3
Q

poditive nodes for classyfying in lung CT

A

> 10mm in short axis

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4
Q

differetial for spiculated mass

A

tuberculoma

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5
Q

Brock uni score

A

likelihood of cancer in lesion on CT - proven to be cancer in the next 2-4 years.

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6
Q

chest radiograph - dene ribs

A

consider haemotologialdiseases - mylefibrosis

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7
Q

ILD - IPODS

A

irradiation
pets
occuption
drus
smoking

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8
Q

IPODS is useful mnemonic for reporting what

A

HRCT

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9
Q

important history for ILD

A

HIV
medication s
VTE
autoimmune conditions

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10
Q

DCC for reporting pattern

A

Describe - which zone is it in, greater in some areas compared to others
Chronology
context

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11
Q

ILD types - smoking related

A

RBILD DP

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12
Q

ILD types chronic fibrosing

A

NSIP UIP

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13
Q

ILD types subacute

A

COP

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14
Q

ILD types rare

A

PPFE and lymphoid interstial pneumonia

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15
Q

ILD - fibrosing conditions need to be seperated from what?

A

hypersensitivity

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16
Q

Hypersensitivity reaction respond well to what common drug

A

steroid

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17
Q

ILD - cyst findings think -

A

Langerhand cell histiocytosis, lymphangioleiomyomatosis

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18
Q

ILD - perilymphatic nodules think

A

sarcoid, chronic berylliosis, lymphangitic carcinomatosis, lymphoma

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19
Q

ILD - centrilobular nodules think

A

Hypersensitivity pneumonitis

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20
Q

ILD - tree in bu

A

infection , aspiration, bronchiolitis

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21
Q

cystic vs reticular in ILD

A

cysts - lymphangiomyomatosi

???

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22
Q

Hypersnesitivity things to look for

A

Central and peripheral
air trapping
spare angles - at the bottom it is clear

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23
Q

Hypersnsitivity lungs can be classified into two what are they

A

fibrotic

non fibrotic

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24
Q

NSIP
interstitial pneumonitits - what to look for

A

Peripheral
lines and Ground Glass
Basal

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25
Q

UIP
- what factors to look for

A

Honeycombing
peripheral and basal

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26
Q

Rheumatoid - what drug can cause pneumonitits?

A

Methotrexate

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27
Q

scleroderma features

A

bronchial dilatation

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28
Q

consoidation moving from place to place

A

cryptogenic organising pneumonia
ATOL sign

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29
Q

thymus is split is a sign of

A

angels wings
paediatric films
pneumomediastinum

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30
Q

thymus should be what

A

bilobed
homogenous
in the right location

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31
Q

which is better cholecystostomy vs hot cholecystectomy

A

recent CHOCOLATE trial - compared.
Hot lap chole did better

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32
Q

Osteochondromas is what

A

bone dysplasia

main feature is bone remodelling and exoptosis

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33
Q

fibrous corticol defect can also be called

A

non ossified fibromas

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34
Q

Osler webber randu

A

Automsommal dominant create fistulas

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35
Q

why do mets enhance?

A

break the blood brain barrier

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36
Q

N O D

A

Neoplasm
Opportunistic infeciton
Drugs

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37
Q

Multiple leukoencehpalitis is caused by

A

JC virus

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38
Q

Thyroid nodules are graded how?

A

1 - 5 TYRADS score from US

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39
Q

Do you biospy thyroid nodules?

A

Some - avoided due to vascular supply - better to do FNA

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40
Q

If find nodule is hot on FDG or PET CT recommend

A

US FNA

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41
Q

FDG avid percentage chance of being malignant?

A

Can be up to 40%

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42
Q

Why do NM thyroid examintions?

A

Hyperthyroidism
Thyrotoxicosis

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43
Q

Iodine 131 used for

A

treatment

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44
Q

Iodine 123

A

diagnostics

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45
Q

Technetium half life

A

6hrs

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46
Q

photons from technetium

A

140keV

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47
Q

Iodine 123 kV

A

190keV

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48
Q

Iodine 131 half life

A

8 days

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49
Q

Iodine 131 energy

A

high energy and beta decay (few mm)r

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50
Q

pertechnetate - is treated like what ion in the body

A

Chloride ions

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51
Q

What is the key difference between iodine and pertechnetate in the thyroid

A

Thyroid will incorporate the radioiodine into the hormone and so hangs around longer

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52
Q

Normal thyroid on NM scans is symmetrical or asymmetrical?

A

asymmetrical is normal

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53
Q

Patient asked to swallow during image taken on NM - why?

A

saliva contains the radioracer

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54
Q

What other tissue will take up the tracer aside from salivary glands for pertecnotate (clrodieions0

A

Gastric mucosa

some soft tissue

lactating breasts

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55
Q

what drugs contain idoine?

A

Amioderone

some cough medicine

contrast

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56
Q

Marker on thyroid uptake scans

A

ankle of louis for retrosternal growth

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57
Q

how to review the intensity of thyroid uptake?

A

compare to adjacent structures - salivary glands

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58
Q

when reviewing the thyroid scans what do you look for

A

intensity
whether it is homogenous it

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59
Q

Pyramidal lobe is visible on thyroid uptake scans

A

pathopnemonic for Graves disease

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60
Q

how do you block thyroid in Graves?

A

Carbimazole

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61
Q

Does carbimaozole affect the scan?

thyroid scanning

A

Doesn’t affect if using it pertecnotate

Iodine 123 - it would as the carbimazole will reduce the uptake of iodine into the thyroid

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62
Q

if hyperthyroid with reduced thyroid uptake - what is group of thyroid conditions

A

Thyroiditis like de Quervains

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63
Q

strumae ovari can produce what type of tissue rarely

A

thyroid tissue

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64
Q

de quervains is often how long after a viral infection

A

a few weeks

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65
Q

Causes of plexopathy after surgery?

A

can be due to extension of the nerves

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66
Q

OPLL happens where

A

Th cervical spine
calcifiaction adjacent to the spinal cord

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67
Q

condyle vs coronoid

A

condyle is bigger

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68
Q

Lamina dura is what

A

the line outside healthy teeth

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69
Q

Periodontal ligament

A

adjacent to the tooh

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70
Q

what can happen to the lamina dura in a fracture?

A

it can also fracture

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71
Q

how to tell a tooth abscess?

A

look for disappearance of the lamina dura

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72
Q

commonest mandibular cyst

A

dentigurous cyst - noramally around a non erupted tooth. Can have a bubbly appearance.

Can be an ameloblastoma

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73
Q

hyperexpansion of the mandible?

A

can be fibrous dysplasia

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74
Q

Eagles syndrome?

A

ossification of the stylohyoid muscle

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75
Q

what is radio osteo necrosis

A

can get pathological fractures from this .

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76
Q

CT sinsues - agressive pathology

A

infection
tumour

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77
Q

non aggressive CT sinsues pathology

A

plasmacytoma / myeloma

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78
Q

CT sinsues - most pathology is…..

A

benign

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79
Q

Which plane best for the sinuses?

A

coronals

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80
Q

Osteomeatal complexes - why is this key in CT sinsues

A

?????

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81
Q

why are ct sinuses pixelly on imaging?

A

low dose only required given the excellent contrast between structures.

different to high penetration needed for inner ear due to petrous bone

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82
Q

Halleras air cell?

A

air cell under the orbit

can cause orbital dihiscence during surgery

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83
Q

uncinate process on the inferior border of osteomeatal complex - what does operating on this do?

A

widens the exit from the sinus

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84
Q

LMG is now called

A

variant of Wegeners

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85
Q

expanded sinus with a polyp occuyping the nasal cavity and posterior space - called?

A

anterocoranal polyp

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86
Q

cinsu poylyp in young men - cherry red on endoscope. ENT are advised not to biospy due to being vascular?

A

juvenile angiofibroma

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87
Q

juvenile angiofibroma will appear as what on MRI

A

salt and pepper appearance

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88
Q

what is an cholesteatoma ?

A

in inner ear - cholestrol cells deposits that invades the ear and surrounding bone.

lots of moving nearby structures, more erosions.

hard to discern from inner infection.

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89
Q

concha bullosa

A

normal variant
airated middle turbinate

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90
Q

lamina propurechea - what to look for?

A

erosions.

can be from a frontal muccele

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91
Q

tetth best looked in what plane?

A

saggital

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92
Q

20% of sinuses disease may be related to what?

A

Teeth

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93
Q

bronchiectasis - features on radiographs

A

kind of thickened bronchus, nearly tram lines levels.
cysts

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94
Q

air trapping shows as what on CT

A

areas without blood vessels, oligaemic

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95
Q

Kartageneres - get what in the sinuses?

A

thickened mucus / walls

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96
Q

ring sign - considered with what condition of bronchiectasis

A

cystic fibrosis

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97
Q

massive bullous emphysema caused by

A

ALpha anti trypsin disease
cannabis smoking (allergic reaction)

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98
Q

cause of bronchiectasis with difficulty swallowing?

A

aspiration

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99
Q

Traditional types of bronchiectasis

A

cystic
varicose
cylindrical

old version

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100
Q

practical way of classifying bronchiectasis

A

primary - idiopathic, primary bronchial disease like ciliary dysmotiity

secondary - aspirations,

or both like TB

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101
Q

worse type of bronchiectasis to get

A

cystic and varicose

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102
Q

Traction bronchiectasis is seen in….

A

NSIP
UIP

but not a primary bronchiecctic disease as the interstiital disease is what pulls open the bronchi

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103
Q

Definie bronchiectasis

A

Artery to bronchus ratio on CXR. 0.9 to 1 in UZ. 1.1 to LZ. But

on CT
more precise
normal range of different in ratio of us to 1.3.
signet ring sign
fishermans ring

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104
Q

fishermans ring is named aftre whome?

A

Pope.

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105
Q

Tramline sign -

A

seen on CXR/ thickened and dilated bronchi.

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106
Q

Finger in glove sign

A

thickened bronchi with ffluid in it

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107
Q

signet ring sign -

A

the bronchi are much bigger than associated artery. Looks like a flashy diamond ring.

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108
Q

bronchiectasis can arise in immunocompromised patients. Form

A

asperigillomas
- growth into a cavity that preo-exists

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109
Q

bronchiectasis can arise in immunocompromised patients. Form

A

asperigillomas
- growth into a cavity that preo-exist

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110
Q

signs of gout

A

soft tissue swelling
tophi in soft tissue
deformity
does not affect bone density

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111
Q

rib notching caused by

A

coartation blood diverison through intercostals

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112
Q

radiographs - fallen fragments are what?

A

bone falls within cysts - diagnosis of humeral cysts

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113
Q

SUV stand for?

A

standard uptake value in Nuclear medicine

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114
Q

SUV of mediastinum

A

2.3

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115
Q

SUV of lung

A

0.9

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116
Q

how can axillary lymph nodes be avid with nuclear uptake but not related to underlying disease?

A

vaccinations

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117
Q

Nuclear medicine normal variant - supraclavicaular fossa

A

brown fossa

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118
Q

radiograph - onion skin reaction sign?

A

bone tumour likely
it is formed by bone growing in layers as the less aggressive tumours grow more slowly

119
Q

high density lesion within the sinuses causing dehiscences

A

asperigullus / chronic fungal infection

120
Q

silvian fissure best seen in what age group?

121
Q

obtuneded, had a fit - what subtle signs can you look for?

A

Encephalitis affects temporal region

supperior saggital sinus thrombosis

121
Q

obtuneded, had a fit - what subtle signs can you look for?

A

Encephalitis affects temporal region

supperior saggital sinus thrombosis

parafalxine lucency sign - from subdural empyema

122
Q

why is periosteal reaction limited in the digits?

A

tightly adhering periosteum

123
Q

raindrop lesions in bones is classic for what?

124
Q

does osteosarcoma make or erode bone ?

A

both

mets have bonew in them
lesions will allso be errosive

125
Q

terminal tuft resorption
speckles of calcification

A

acro-osteolysis

scleroderma

126
Q

scleroderma get what interstital lung fibrosis

127
Q

commonest type of hyip dysplasia

A

achrondoplasia

128
Q

why is mycoplasma considered atypical?

A

it has no cell wall so won’t grow on agar plates.

129
Q

on fluro what is shouldering?

A

consider whether a mass is obstructing a lumen completely, is intramural and invading towards the lumen or whether something is extra.

inter, intra and extra lumanal lesions.

shouldering is the shape a mass makes into the lumen

130
Q

odynophagia means what?

A

Painful swallowing

131
Q

corkscrew oesophagus

A

oesophageal dysmotility - common of the elderly.

132
Q

chest mouse

A

pleural fibroma (large, soft tissue density, can be a bit mobile)

133
Q

what is epiploic appendage apendicitis

A

leave them be.

133
Q

snow cap appearance on radiograph

A

avascular necorsis

can be due to sickle cell

134
Q

how does ketamine affect the bladder?

A

releases toxins that affect the urothelium. bladder gets inflamed and fibrosed and small.

135
Q

what else can ketamine affect beyond urothelium?

A

biliary tree

136
Q

beading of the renal artery? multiple septations - diagnosis to consider

A

fibromusculardysplasia

137
Q

Asbestos compensation in UK? What counts?

A

Mesothelioma
?possibly rounded atelectasis
pleural thickening

138
Q

relationship of asbestos fibres and location of malignancy.

A

inhalation toxins normally affect mid and upper lobes

asbestos fibres tend to go to the lower lobes.

139
Q

asbestosis

A

subpleural lines
plaques

140
Q

asbestosis - diffuse pleural thickenin gaffect on lungs

A

can pin the lungs to the diaphragm, prevents movement of diaphragm.

reduces lung function

141
Q

worst asbestos fibre

A

crocidolite

142
Q

mimics of mesothelioma

A

metastatic thyomoma
pleural fibroma (lungmouse)

143
Q

MARS 2 asbestos trial

A

chemo vs surgery

chemo doing better

144
Q

silicosis will appear as what?

A

PMF
progressive massive fibrosis

145
Q

why does grey turners sign happen?

A

the tripsinogen released from the pancreatitis allows for easy penetration of the retroperitoneum.

146
Q

what is disease specific mortality improvement?

A

Its not all cause mortality - much easier to fund and prove DSMI.

147
Q

Issues with all cause mortality?

A

hard to recruit

148
Q

what is aducanumab

A

for alzheimer

149
Q

How do Neuroendocrine tumours allow a radionuclide to attach?

A

Amine precurosr uptake and decarboxylation (APUD) mechanism

150
Q

What do somtatostain rececptor scintography attach to?

A

somatostain.

151
Q

What radionucleotides are used for NETs

A

Indium-111(111In) octreotide
Technetium-99m (99mTc) octreotide
Positron-emission tomography (PET)-CT gallium-68 (68Ga) peptide

152
Q

Lady windeeer lung? Called why?

A

Oscar WIlde charachter, supressing cough thought todevelop MAI.

Bacterial infection

153
Q

How is MAI cultured?

A

with difficulty

154
Q

Treatment of MAI ?

A

6 months course of abx
?dual or triple

155
Q

MRI brachial is what?

A

cronorol t1
stir
oblique clavicle of affected side

156
Q

Scalene muscle on MRI brachial is important for what reasons?

A

ensures looking at 1st rib (not an accessory rib)
nerve roots go behind the salene (nbetween the anterior and posterior)
anterior scalene divides the artery (anterior) and the vein (posterior)

157
Q

External ear pathology
Infections and inflammatory

A

NEC OE
Keratosis obyurans
Medial canal fibrosis
EAC cholesteatoma

158
Q

External ear
Benign and malignant tumors

A

eAc osteoma
eAc exostosis
eAc scc

159
Q

Prussak space is where what is commonly found

A

Commonest location of cholesteatoma

160
Q

Small spleen causes

A

Fanconi
Coeliac
Sickle cell

161
Q

Pancreatic tumour - how to measure

A

Tnm 8
Measurements important in staging.

162
Q

Is measuring kidney size useful

A

Not really.
Left normally a bit bigger than right.

163
Q

what age do you do mammography on? for symptomatic

A

aged 40 and over

164
Q

If maignancy is confirmed, is mamoogram required no matter what the age?

165
Q

What condition is a mamogram done on younger women 35- 39

A

if P4 or P5 and or U4 / U5

166
Q

what extra mammogram views are there?

A

MLO
CC
digital breast tomosynthesis,
compression
magnification

167
Q

Indications for symptomatic mamography

A

lump
nipple symptoms (retraction, discharge, persistent unilateral eczema)

168
Q

BI-RADS - for breast density are between what parameters

A

1 - fatty breasts
2 - scattered areas of fibroglandular density
3 - heterogeneously dense
4 extremely dense

169
Q

What are we thinking when we see Tea cupping on mammorgrams?

A

Reassuring. / benign.

170
Q

What is tea cupping

A

Benign calc can often sit in a cyst. The calc will be at the edge of the cyst and so considered benign

171
Q

how do you assess an area of distortion on a mammogram?

A

state you would want tomosynthesis or paddle viewed (less used)

172
Q

mammogram - how to rate suspicion of malignancy?

A

M1 normal
benign
probably benign
suspicious for malignancy

m5 malignant

173
Q

radial scar can mimic a

174
Q

mammogram - flame shaped density

A

gynaecomastia

175
Q

when is an Eklund views used?

A

in breast implants to get better view of the breasts

176
Q

benign breast lesions

A

fat necrosis
lipoma
hamartoma
glactoceole
intramammary lymph nodse
phylloides tumours
abscess
haemartoma

177
Q

what are malignnat charachteristics on mammograms?

A

spiculated
illdefined
parchitectural distoraiton
parenchymal asymmetry
malignant calc, irregular, tiny, rod like

178
Q

mets pattern of invasive lobular carcinoma

A

peritoneum
GI / GU tracts
letoominiges
myocardium

179
Q

Invasive lobular carcinoma has what receptor positvity

180
Q

how does ILC show on a mammorgram

A

distortion
spiculated mass
sometimes fails to form a palpable lump

181
Q

skin breast thickening implies what

A

infalmmatory breast carcinoma

182
Q

inflamatory breast carcinoma can mimic

183
Q

age for inflammatory breast carcinoma

A

40s to 50s

184
Q

what is a brast fibroadneoma

A

overgrowth of connective tissue

185
Q

When can you not biopsy lesions ?

A

presumed fibroadenoma under 25 years
fat necrosis with trauma history
imaging a typical of lipoma or hamartoma
multiple lesions (don’t need to biopsy all of them)

186
Q

what U level do you biopsy in breast

A

U3 and above (U5)

187
Q

most common mets to the breasts

A

ovaria
lung
sarcoma

188
Q

haemorrhagic breast mets

A

melanoma
rcc
choriocarcinoma

189
Q

pthological nipple discharge

A

unilateral
spontaneous
sing duct orifice

190
Q

most prostate cancers are what type

A

95% adenocarcinoma

191
Q

where does prostate cancer direct spread into

A

bladder and seminal vesicles

192
Q

anatomy of prostate is what?

A

central zone
transitional zone
peripheral zone

193
Q

most cancers are where in the prostate

A

peripheral zone

194
Q

PRIADS difference between Pirads 4 and 5

A

only size, greater than 1.5cm

195
Q

difference bettween T3a and T3b in prostate cancer

A

A is abuting the capsue

B - invades seminal vesicles

196
Q

why work out prostate density

A

work out the PSA in relation to the size of the prostate

197
Q

why is prostate volume important?

A

if planning radiotherapy need to know if can get to all prostate

198
Q

type of prostatre T2 imaging

A

axial images

199
Q

mullerian ducts form what

A

fallopian tubes
uterus
cervix
upper 2/3 ofthe vagina

200
Q

genital rdige froms what

201
Q

T1 FS gynae to review for

A

haemorrhage

202
Q

how to assessth euterus on imaging?

A

presence
shape
external contour
internal indentation in uterine cavity
carvix and vagina
kidneys

203
Q

Haematocolpus, what is it

A

retention of menstruation

204
Q

types of germ cell tumour

A

mature ovarian teratoma

immature ovarian teratoma

ovarian dysgerminoma

choriocarcinoma

205
Q

liver mri - T1 - why?

A

exploit intrinsice t1 signal
see if fat or iron in a lesion
melanin also

206
Q

liver mri - T1 - why?

A

exploit intrinsice t1 signal
see if fat or iron in a lesion

207
Q

in and out of phase. how should a healthy liver look

A

no big diference in colour of parenchyma
5% loss of singal - mild fatty
10 - 50% moderate fatty change

208
Q

T1 liver mri Signal similar to spleen

A

think metastatis

209
Q

T1 liver mri Signal similar to liver

210
Q

fat on out of phase imaging should be WHAT in relation to in phase

211
Q

liver lesions that bleed

A

HCC
adenoma

melanoma

212
Q

Multi cystic vs polycytic disease

A

multi - there is intervening parenchyma present

213
Q

biliary hamartomas are also called

A

von meyeberg complexes

214
Q

liver complex cyst - differnetials

A

copmlex cyst
hydatid
cystic metastasis

215
Q

what is shine through

A

on T2, they are bright. So they don’t get any DWI infor from them

216
Q

features of liver benign lesion

A

well marginated
smooth margin
homogeoujs
<20HU

217
Q

haemagioma enhacnement pattern

A

nodular peripheral enhancemenet

218
Q

mother in law phenominan for haemangioma

A

contrast arrives early and leaves late

219
Q

what is FNH?

A

hyperplasia of kupffer cell, biliary ducts and blood vessels.

some people think there is an insult.

220
Q

FNH on MRI

A

homogenous lobulated lesion, well demarkated, central scar of high T2 signal.

late enhancing scar

221
Q

Neonatal X-Ray: what are the indications`?

A

lines and tubes
respiratory distress
antenatally diagnosed pathology
monitor treatment
suspected bowel obstruction
NEC

222
Q

what do neonates have in front of the heart

A

thymus

state cardiothymic contour

223
Q

What course does the umbilical artery catheter take

A

umbilical catheter, internal iliac then up to common and aorta.

224
Q

umbilical artery caatheter tip should be located

A

T6 - T10

(avoid renal veseels)

225
Q

umbilical vein catheter course

A

left portal vein, then ductus venosus, middle hepatic vein, IVC, right atrium

226
Q

what is the ductus venosus

A

open in first few days of life between portal and systemic blood

227
Q

tell difference between umbilical vein or artery catheter

A

artery will dip down to the iliac before coming up

228
Q

Neonatal X-Ray - ET tube - how to measure location

A

go on vertebral body projected over

229
Q

Neonatal X-Ray - Term baby lung pathologies

A

meconium aspiraiton
neonatal pneumonia
transient tachypnoea of the newborn
congenital heart diseasea

230
Q

Neonatal X-Ray - pre-term baby lung disease

A

SDD
neonatal pneumonia
TTN
CHD
pulmonary interstiital emphysema
chronic lung diseases of prematurity

231
Q

what is pulmonary interstitial emphysema

A

premature lungs are stiff
if ventilated get tiny blebs forming in the lungs

232
Q

CTR in neontal xr

A

up to 0.6 is accessible

233
Q

Commonest cause of death in preterm neonates

A

Surfactant deficiency disease

especially pre 32 weeks

234
Q

Surfactant deficieny disease cxr findingd

A

diffuse bilateral granular, air bronchograms, no pleural effusions.

wide differential so clinical history important

235
Q

Neonatal X-Ray - pulmonary oedema is noramlly suggestive of

A

Congenital heart disease

236
Q

Neonatal X-Ray shows pulmonary oedema - what can you recommend

A

echo for CHD

237
Q

if Neonatal X-Ray CTR is greater than 0.6 recomend

238
Q

Neonatal X-Ray - boot shaped contour

A

tetraology fallot

239
Q

n a string sign

240
Q

snowman shape

241
Q

thymic sail sign

A

normal thymus

242
Q

spinnaker sign Neonatal X-Ray

A

pneumomediastinum
thymus outlined by gas

243
Q

Neonatal X-Ray - abod signs of free gas

A

football sign
cupola sign
falciform ligamnet sign
riglers signs

244
Q

lateral decubitus - look where for free gas

A

around the liver

245
Q

Neonatal gut obstruction - how to categorise

A

Physiological
- delayed meconium

Anatomical
- atreisa

Funtional
- nec / hirshsprungs

246
Q

how to differentiate neonate of diabetic mother vs Hirshsprungs disease

A

The HD is a histological diagnosis with cone segment at the splenic flexure.

IDM can appear as cone segment

247
Q

meconium plug syndrome vs HD - more common in pre term or term

A

Pre term babies - meconium plug syndrome

Term - HD (and in boys)

248
Q

frequent location of HD starting ?

A

zone of transition at the rectosigmoid junction.

249
Q

contrast enema twitchy rectum

250
Q

how to tell the difference between large and small bowel in a neonatal radiograph

A

you can’t

251
Q

pre-term infants develop physiological jaundice within the first 2 weeks of life due to immaturity of the enzyme

A

glucuronosyl transferase

252
Q

intrahepatic causes of neonatal jaundice area

A

Bile duct paucity: Alagille syndrome, non-syndromic
Neonatal sclerosing cholangitis

Parenchymal disease: Byler disease (progressive familial intrahepatic cholestasis), idiopathic neonatal hepatitis

Infection: cytomegalovirus (CMV), rubella, herpes simplex, Coxsackie B virus, echovirus, congenital syphilis, toxoplasmosis

Toxic/metabolic: total parenteral nutrition (TPN), alpha-1 antitrypsin deficiency, cystic fibrosis, galactosaemia, tyrosinaemia

Endocrine: hypothyroidism, panhypopituitarism

253
Q

commonest liver related neonatal jaundice causes

A

biliary atresia or neonatal hepatitis

254
Q

extra hepatic causes of neonatal jaundice

A

Biliary atresia
Choledochal cyst
Bile plug syndrome
Cholelithiasis
Spontaneous perforation of the common hepatic duct
Duodenal duplication

255
Q

BASM stands for

A

biliary atresia with splenic malformation

256
Q

triangular cord sign

A

biliary atresia

257
Q

cyst at the porta hepatis

A

biliary atresia

258
Q

if biliary atresia is suspected on US what is the next imaging

A

Hepatobiliary iminioacetic acid (HIDA) is performed

259
Q

What can HIDA also look like?

what is the next investigations

A

Biliary tree paucity or severe hepatitis

biopsy

260
Q

what are choledochal cysts?

A

dilatations of the biliary tree.

T1 - T5

261
Q

jaundiced neonate - first line imaging

262
Q

WHAT IMAGING IS done after USS for jaundice in neonate

A

depends on obstructive or non obstructuve.

HIDA - non obstructive (biliary atresia)

choledochal cyst (MRI)

263
Q

BASM occurs in WHAT proportion of biliary atreisa

A

10-20% of cases.

264
Q

Only about XXXXX of choledochal cysts present in the first year of life.

265
Q

three phases of swallowing?

A

oral
pharyngeal
oesophagel

266
Q

Wiedemann syndrome predispose to child to the development of

A

hepatoblastoma.

267
Q

most common causes of hepatomegaly in very young children are:

A

Cardiac failure
Neuroblastoma stage 4S
Haemangiomas
Metastases from neuroblastoma stage 4
Hepatitis
Metabolic disease and infiltration in storage disorders
Biliary atresia

268
Q

Neuroblastoma 4S typically metastases

A

liver, bone marrow and skin

269
Q

Causes of hepatomegaly in older children

A

Hepatoblastoma
Mesenchymal hamartoma
Hepatocellular carcinoma
Undifferentiated embryonal sarcoma
Metastatic disease
Cystic disease
Infiltration and infection
Focal nodular hyperplasia and adenomas

270
Q

paeds fatty liver causes

A

fatty liver include chemotherapy, steroid therapy, malnutrition and obesity.

metabolic disorders

271
Q

sive polycystic kidney disease (ARPKD) is an inherited disorder which causes widespread cystic renal disease and hepatic WHAT

272
Q

A large cystic hepatic lesion in a child <2 years of age is virtually diagnostic of a

A

mesenchymal hamartoma

273
Q

paeds chest xr - snowman heart shadow

A

supracardiac total anomalous pulmonary venous drainage (TAPVD)

274
Q

You are reviewing the x-ray of an 88-year-old man’s lumbar spine. He is known to have a large abdominal aortic aneurysm which has been deemed non-operable.

Which of the following findings is most in-keeping with this diagnosis?

A

Posterior vertebral beaking
0%
Anterior vertebral beaking
2%
Anterior vertebral scalloping
94%
Widened interpedicular distance
1%
Posterior vertebral scalloping

275
Q

heamangioma on MRI

A

T1 and T2 bright

276
Q

Preiser

277
Q

Ahlback

A

Medial femoral condyle (i.e. SONK)

278
Q

Blount

A

Proximal medial tibial epiphysis

279
Q

Scheuerman

A

juvenile kyphosis

280
Q

Panner

A

Capitellum

281
Q

This facial cancer spread through compartments

282
Q

Deep cervical fasica extends from the skull base to the

283
Q

middle cervical fasica extends down to the

A

thoraic inlet

284
Q

retropharyngeal space extends down to the

285
Q

v1n-3 trigeminal travel through which foramen

A

OVALE V3
MAxillary V2
Superor orbital fissure for V1

286
Q

lateral ptserygoid has which muscle on it

A

horizzontal. PROTRACTS THE JAW

287
Q

medial pterygoid muslce does what action

A

side to side grinding

288
Q

Parotid can be divided by

A

Facial nerve
external carotid
retromandibular vein.

289
Q

glands don’t have lymph nodes - why?

exception ?

A

they are encapsulated befroe the lymph system develops

paraotid can have lymph nodes as they encapsulate later

290
Q

prevertebral abscess if you cant see

A

Longus coli

AA ST2 (14 decks)

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